Active NPI
Laura Marie Breese, ATC
- Athletic Trainer
- Elyria, OH
National Provider Identifier
1205958667
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 1520
- Practice address
- 137 Winckles St
Elyria, OH 44035-6151 - Phone
- (440) 366-5993
- Fax
- (440) 366-5313
- NPI assigned
- Apr 5, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 1520 | OH | Primary |
Addresses
Primary practice location
137 Winckles St
Elyria, OH 44035-6151
Mailing address
144 Stanford Ave
Elyria, OH 44035-6010
Phone (440) 322-8210
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1520 | OH | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jaworski Physical Therapy Inc | Past | Accepting new patients | |
| Jaworski Physical Therapy Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464652800000",
"number": "1205958667",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "144 STANFORD AVE",
"city": "ELYRIA",
"state": "OH",
"postal_code": "440356010",
"telephone_number": "440-322-8210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "137 WINCKLES ST",
"city": "ELYRIA",
"state": "OH",
"postal_code": "440356151",
"telephone_number": "440-366-5993",
"fax_number": "440-366-5313"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BREESE",
"first_name": "LAURA",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-05",
"last_updated": "2016-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "OH",
"license": "1520",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elyria, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.